NCHIMA | Optimize Health Care Revenue Cycle Operations with Robotic Process Automation (RPA)

Robotic Process Automation (RPA) has proven to be an important technology for the automation of manual processes. Hospitals are implementing RPA to respond to the challenging environment that currently exists in health care.


Robotic Process Automation (RPA) has proven to be an important technology for the automation of manual processes.  Hospitals are implementing RPA to respond to the challenging environment that currently exists in health care.  This advanced technology helps hospitals to streamline operations, reduce the time to complete tasks, improve financial performance, and lower labor costs.  It is easily used for common tasks that can be replicated, like queries, cutting and pasting, etc; however can also be trained to automate more complex task including denials management, authorization management, claim edit resolution, and other processes. 

How does it work?  It uses custom programmed processes (robots) that have access to applications and data sources, including end-user health information systems, data input screens and online application programming interfaces.  These robots act as a revenue cycle representative who would normally complete these tasks. While other solutions require you to log into their system, Robotic Process Automation bots log into your systems.

Since RPA leverages artificial intelligence, the virtualization technology can be easily scaled and deployed across hospitals and various geographic locations.  

The benefits are significant.  When RPA is successfully implemented, it can result in:

  • Gather information from websites and other applications to integrate information directly into the HIS and submit pre-authorizations
  • Clean up eligibility mistakes including Government Managed Care eligibility
  • Respond to payor denials by generating online appeals automatically
  • Automate steps within manual processes to speed up human staff and improve productivity
  • Reduce manual data entry
  • Improved efficiency allows for data sharing between third-party processes and tools
  • Automate simple billing edit resolution

Organizations that have implemented have reduced costs by 30-70% depending on processes deployed.  According to Becker’s Hospital CFO Report, some organizations have increased their team capacity from 35 to 200%, so they can focus on higher priority, problem-solving tasks. 


  • Understand the benefits of implementing RPA
  • Assess whether to build or buy your own RPA platform
  • Identify efficiencies from RPA
  • Understand how workflow tools and performance analytics can improve the experience with RPA

Date Published:

October 6, 2020


1.0 – Informatics, Analytics and Data Use


Andrew Woughter

Andrew Woughter is the Senior Vice President of Product Strategy at nThrive where he focuses on innovation. He led the introduction and development of Robotic Process Automation as a capability at nThrive. He is a proven revenue cycle executive with 19+ years of experience in healthcare organizations and governmental regulation of health insurance.  He has led revenue cycle teams for a broad variety of provider types, and has significant experience working with software and services vendors to improve revenue cycle processes and solutions.  He has demonstrated success through strategic vision and innovation and development of custom tools to enhance revenue cycle solutions. 

Andrew is a graduate of Bethel University in St. Paul, MN, and lives in Texas with his wife and two sons, ages 4 and 7. He loves taking the family to Disney and seeing the magic on his kids faces.


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